After a momentous week in which our political system yet again surprised us, I headed off to Liverpool for the annual NHS Confederation Conference to find out what the new Government was planning and what everyone made of it.

The memory is still fresh for me of the 2010 conference when the new coalition government had arrived. I remember reading the coalition agreement beforehand and thinking ‘so they are about to do something to dismantle PCTs’. (And little did we all know just how much ‘dismantling’ lay ahead!) I recall the PCT abolition announcement and many shocked PCT Chief Executives and staff wandering around the rest of the conference like rabbits in the proverbial headlights.

So, I listened with interest to Jim MacKey (Chief Executive, NHS Improvement), Simon Stevens (Chief Executive, NHS England), and Jeremy Hunt (Secretary of State: yet again. The most ‘reappointed’ one ever!)  What struck me was the sense of;

  1. A great job done over the last year by the NHS despite everything, and
  2. ‘General Election, what election?’

The priorities and ways of working were to continue as before. The difference being that there wasn’t likely to be access to legislation to enable the inevitable and heavily promoted move to integration whether in sustainable and transformation partnerships or in accountable care systems/partnerships/organisations. Intriguingly the Secretary of State said he was open to cross party agreement on new legislation.

I attended a number of sessions which highlighted the great work underway to pull the system together in various ways: ambulance services and enhanced clinical decision-making in London and South Central, integrated care in Anneurin Bevan Health Board, building accountable care in Blackpool, ‘diabetes san frontiers’ in Reading and the Somerset Symphony project building real collaboration.

These stories, the regular citing of each other’s comments by the NHS leaders and a general sense of alignment created a very different mood from that of only two years ago and I was left wondering whether Simon Stevens was destined to also fill Jim’s shoes later this year to stitch things together even further.

As I boarded my train home Jim Mackey’s words resounded in my ears. “Eventually it will all make sense again.”


Alastair Mitchell-Baker is a Director of Tricordant. To discuss further, please contact him at